title: Temperature management in haematology patients with febrile neutropenia: a practice survey.
abstract: OBJECTIVE
  To assess the attitudes of clinicians to temperature management in haematology patients with febrile neutropenia.
  
  
  METHODS
  An online scenario-based survey was circulated to consultant members of the New Zealand branch of the Haematology Society of Australia and New Zealand, to haematology advanced trainees, and to nursing representatives at each haematology department in New Zealand.
  
  
  RESULTS
  Eighty-eight responses were obtained, from 34 doctors and 54 nurses. Most respondents would advise a neutropenic patient to take paracetamol as needed for pain. Median temperature intervention threshold for an asymptomatic patient with febrile neutropenia was higher for doctors than for nurses (38.5 versus 38.0 degrees Celcius), despite considerable heterogeneity. Both groups indicated they would intervene at a median 38.0 degrees Celcius for a patient with rigors. Paracetamol was the preferred first-line cooling measure, with physical methods second-line, and pethidine third-line. All respondents favoured oral over intravenous or rectal paracetamol. Most believed a clinical trial of antipyretic treatment for febrile neutropenia was warranted, and indicated willingness to enrol their patients in such a study.
  
  
  CONCLUSIONS
  This survey documents clinicians' preferred temperature intervention thresholds and methods for haematology patients with neutropenic fever, and shows considerable variation in practice. Most respondents supported a trial of antipyretic management in febrile neutropenia.
authors.affiliation: Wellington Blood and Cancer Centre, Wellington Hospital, Private Bag 7902, Wellington 6242, New Zealand. Robert.Weinkove@ccdhb.org.nz
authors.forename: Robert
authors.initials: R
authors.lastname: Weinkove
authors.forename: Jennifer
authors.initials: J
authors.lastname: Clay
authors.forename: Catherine
authors.initials: C
authors.lastname: Wood
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D058633:Antipyretics / Q000627:therapeutic use*; D017679:Cryotherapy; D005334:Fever / Q000150:complications / Q000628:therapy*; D006405:Hematology / Q000379:methods*; D006801:Humans; D008614:Meperidine / Q000627:therapeutic use; D009503:Neutropenia / Q000150:complications / Q000628:therapy*; D009520:New Zealand; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index
chemical_list: D058633:Antipyretics; D000082:Acetaminophen; D008614:Meperidine